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目的 发现非肿瘤肺部疾病对肺癌危险度的直接影响。方法 在甘肃省进行的病例-对照流行病学研究,涉及到在1994年1月至1998年4月期间发生的886名肺癌病例(男性656名,女性230名)。病例调查表中收集了多种诱发肺癌危险因素的资料,其中包括非肿瘤肺部疾病史(肺结核,慢性气管炎/肺气肿,哮喘,肺炎),初次发病诊断年龄和年份,接受治疗和住院情况等。通过分析这些资料,找出非肿瘤肺部疾病史与肺癌危险度的关系。结果 在对主动吸烟和社会经济因素进行调整后,发现肺癌危险度的增加与肺结核及慢性气管炎/肺气肿直接有关,其比值比(OR)和95%置信区间(CI)分别为OR=2.1(95% CI:1.4～3.1)与OR=1.4(95％ CI:1.1～1.8)。哮喘与肺炎也使肺癌OR值增加,其值分别为OR=1.4,(95% CI:0.9～2.1)与OR=1.5(95％ CI:1.0～2.3)。当只对有病理诊断的病例和由本人回答的资料进行分析时,肺结核与慢性气管炎/肺气肿导致肺癌危险度的增加也是显著的。结论本研究提供了新的证据,证明以往的肺结核与慢性气管炎/肺气肿使致肺癌危险度显著增加。哮喘和肺炎与肺癌的关系虽然也是正相关,但还没达到统计显著水平。
Objective To find out the direct impact of non-tumor lung disease on the risk of lung cancer. Methods A case-control epidemiological study in Gansu Province involved 886 cases of lung cancer (656 males and 230 females) that occurred between January 1994 and April 1998. The case-based questionnaire contains information on a variety of risk factors for lung cancer, including non-neoplastic lung disease (tuberculosis, chronic bronchitis / emphysema, asthma, pneumonia), age and year of initial diagnosis, treatment and hospitalization Situation and so on. By analyzing these data, we can find out the relationship between the history of non-tumor lung disease and the risk of lung cancer. Results After adjusting for active smoking and socioeconomic factors, it was found that the increased risk of lung cancer was directly related to pulmonary tuberculosis and chronic bronchitis / emphysema. The odds ratio (OR) and 95% confidence interval (CI) were OR = 2.1 (95% CI: 1.4 ~ 3.1) and OR = 1.4 (95% CI: 1.1 ~ 1.8). Asthma and pneumonia also increased the odds of lung cancer, OR = 1.4, (95% CI: 0.9-2.1) and OR = 1.5 (95% CI: 1.0-2.3), respectively. The increased risk of lung cancer due to tuberculosis and chronic bronchitis / emphysema was also significant when analyzed only for pathologically diagnosed cases and those for which I responded. Conclusions This study provides new evidence that previous tuberculosis and chronic bronchitis / emphysema caused a significant increase in the risk of lung cancer. Although the relationship between asthma and pneumonia and lung cancer is also positively correlated, it has not reached a statistically significant level.